NPIMap

Individual provider Active NPI

Alireza Mahmoudieh, MD

  • Radiation Oncology Physician
  • Merced, CA
National Provider Identifier
1720166309
Registry record updated Jun 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
A90452 Issued in CA
Practice address
3303 M St
Merced, CA 95348-2714
Phone
(209) 726-3410
Fax
(209) 726-3371
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X A90452 CA Primary

Addresses

Primary practice location

3303 M St
Merced, CA 95348-2714

Mailing address

PO Box 511597
Los Angeles, CA 90051-8152
Phone (209) 726-3410

Other identifiers 1

IdentifierTypeStateIssuer
00A904520MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050705000485 CA Practitioner - Radiation Oncology 8527035310 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
El Portal Radiation Oncology CenterGroup PAC ID 3678637378, 5 clinicians

Practice addresses (Care Compare)

3303 M St
Merced, CA 95348-2735
Phone (209) 726-3410

Hospital & facility affiliations

  • Mercy Medical Center Hospital, Merced, CA, CCN 050444
  • Emanuel Medical Center Hospital, Turlock, CA, CCN 050179
  • Memorial Hospital Los Banos Hospital, Los Banos, CA, CCN 050528

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Quality
94.73
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions15
Removal or shaving of skin growth1-10
Skin biopsy92

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A90452CAMDRadiation Oncology Physician

Practice roles (5 of 6)

OrganizationSpecialtyStatusNew patients
El Portal Radiation Oncology Center Radiation Oncology CurrentSince Nov 3, 2008 Accepting new patients
Dignity Health Past Accepting new patients
Sutter Valley Hospitals Past Accepting new patients
Dignity Health Past Accepting new patients
Swedishamerican Hospital Past Accepting new patients

Locations

360 E Almond Ave
#103
Madera, CA 93637
Phone (559) 675-7926

360 E Almond Ave
Ste 103
Madera, CA 93637
Phone (559) 661-1965

3303 M St
Merced, CA 95348
Phone (209) 384-3533

410 E Yosemite Ave
Ste C
Merced, CA 95340
Phone (209) 205-2999

Dept LA 23779
Pasadena, CA 91185

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403568000000",
    "number": "1720166309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 511597",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900518152",
            "telephone_number": "209-726-3410",
            "fax_number": "209-726-3371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3303 M ST",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953482714",
            "telephone_number": "209-726-3410",
            "fax_number": "209-726-3371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHMOUDIEH",
        "first_name": "ALIREZA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2014-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "CA",
            "license": "A90452",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A904520",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Merced, CA

Sources for this page

Verify at the official NPI Registry.